Lung function

I had lung function yesterday and surprisingly was told ""it looked normal"". I am taking pred at the mo (have been for past month) could this have effected the result? Has anyone else had a normal lung function? - I'm now doubting whether I've actually got asthma and worried that drs are going to think I'm making it up!

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hello, yes pred would affect the result by reducing inflammation/swelling/mucus production, so helping your airways function more normally. I presume you were told not to use your bronchodilator before the tests?

it's a great feeling to be told your lung function is normal isn't it? me too - my asthma is classd as severe and I have bronchiectasis too & take a raft of drugs (inc pred) to control both, but on a good day my lung function is quite normal and when this happens I dance out of the clinic on a real high!

I try to avoid lung function tests when my lungs aren't behaving! So what if without the drugs I'd be gasping? the point is that with them I can blow with the best of them! and where I go (RBH) the clinical physiologists are great at helping you perform as well as possible in the tests, really urging you on, which helps

great news I'm really pleased for you!

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hi,

I've had 2 Lung function tests at the RBH, and they were both normal. BUT I was not allowed to do them until I was in top form. ie peak flows at 90% + So I was really well. I am classified as a severe/ difficult asthmatic.

The thing about asthma is that when you are well you are very very well and when you are sick you are dying.

best

Ri

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lucky, i dont think ive ever had a normal lung function test.

The past two times they have been 20% worse than its supposed to be. My doctor is starting to think that my lungs cant do the max anymore. Not too cool.

[yaf_user681_25874]

Hi

Don't doubt yourself... it's just that you happened to go on a good day!

I had a good test result at my appt last week, but that was on the basis of all the meds I'm taking.... My hosp never says don't take anything before the tests, they just record what you have taken.

Consequently when I got my ""normal"" test results (ie my FEV was pretty close to predicted), that was on the basis of having taken all my meds (inc ventolin) in the 2 hours before the test..... interestingly tho, still can't get PF back to what it was last Autumn and still symptomatic on a daily basis (never used to be - and PF was always around 25 - 30% higher than it is now), plus on significantly more / higher doses of meds too.

But as a result of the tests & appt, I am now taking singulair as another add on with an aim to reduce pred gradually and see if can stay stable - if so will look at reducing till I can stop pred altogether.

I do understand it can seriously mess with your mind tho - I have had times in the past where I've thought that its all in my head, and do I really need the meds etc..... especially if you go to clinic at the same times as other people who are struggling and having a bad day....

Try to keep it in perspective and remember - the meds etc are keeping you well and your doctor know what meds you're on so they won't think you are making it up at all - but they just might want to try to reduce some medsi f you stay well.

Kat

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Hi there

Normal lung function when well or adequately treated is very common in asthma and is pretty much one of the hallmarks of the disease - it's often defined as a condition of airflow limitation which is *reversible* spontaneously or with treatment.

Doctors who are diagnosing and treating asthma will never make decisions based solely on one set of lung function tests. They will also look at your own peak flow readings, including any diurnal variation, how much of your reliever inhaler you are using, what other medication you are on and what your day-to-day symptoms are like.

If you do have reduced lung function tests it generally implies that you have undertreated or poorly controlled disease, which would often be an indication for medication to be increased (assuming there is any room for increase).

As people have said below, some severe/difficult/chronic asthmatics, especially those who have had the condition for a long time, do show reduced lung function tests all the time. Sometimes this is due to a fixed narrowing of the airways due to changes in the muscle wall of the airways ('airway remodelling') and sometimes it is because of chronic levels of inflammation and bronchoconstriction despite maximum treatment.

So the fact that you can get normal lung function test results when on effective treatment (eg pred) is actually a very good sign. It doesn't mean that you haven't got asthma or that it is 'all in your head', but it does mean that your asthma has probably not caused any significant permanent damage or changes in your airways - something to be celebrated!

Hope this helps

Em H

[yaf_user681_25874]

Hi Emily

Thanks for taking the time to post this explanation - its very useful to me and I would assume Sarah (original post) too.

It makes me think that when I go back to clinic next time, assuming nothing goes horribly wrong, that I need to ask a few questions -

1 Can anything else be done to get rid of symptoms, let me get back to previous activity levels, and improve pfs back to my previous best, or do I just need to ""learn to live with it""

2 Probably my cons and I should be looking to either reduce pred further/cut it out, or maybe reduce other meds if lung function stays good?

3 I guess I should also ask to review/update my personal plan to reflect latest meds/symptoms etc - probably should do this everytime we make a change, as its well out of date at the moment...

As I said above - your post is really helpful - I wish I got that type of info from visits to clinic/GP rather than just ""lung function is good"" as, as Sarah posted, it can cause you to have doubts later if you don't fully understand what they mean or don't think to ask ""what does that really mean in terms of my asthma etc""

Hope you're having a good day and keep onwith the recovery!

Kat

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I always get normal results. One consultant decided to test the asthma diagnosis with a provocation test. They made me inhale histamine solution through a nebuliser and repeated the test at increasing concentrations. I ended up with a pretty bad attack and that confirmed it to my doctor that it is not all in my head but I cannot say that it was an enjoyable experience.

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There are many other tests used by asthma meds to diagnose asthma and the way in which it is progressing. My chest doc is incredibly hung up re results of nitric oxide tests, - painless – and also a little less comfortable, induced sputum tests which him/they also seem quite keen upon, re ongoing inflammatory processes in the lungs and trying to predict what will happen in the future. Full PFT tests at the same time have been normal or not.

Asthma is a very complicated condition.

Mia